Efficacy of Augmented Food Pantry Services in Addressing Food Insecurity

Abstract

Abstract Objectives Almost 1 in 9 Americans obtain food from a food bank or food pantry every year to help make ends meet. Despite this scope and scale, the efficacy of the charitable food system at alleviating food insecurity is still unclear. This study aimed to determine whether food distributed at food pantries as part of a comprehensive diabetes self-management support program, changed food security status for adults with diabetes. Methods This is a secondary, prespecified analysis of a larger randomized, controlled study (the FAITH-DM trial) conducted in 27 food pantries in Detroit MI; Houston, TX; and Oakland, CA (2015–2018). We screened 5329 adults for diabetes, and individually randomized 568 participants with hemoglobin A1c (HbA1c) 7.5% or greater to an immediate 6-month intervention (including bimonthly food, diabetes education, health care referral and glucose monitoring) or to receive the intervention after a 6-month delay (cross-over design). For this analysis, primary outcome was food insecurity, measured at baseline, 6 months and 12 months, using the 10-item USDA food security modules scaled as a continuous Rasch score and then compared using difference-in-differences analyses. Results Participants were racially/ethnically diverse (51% Latino/Hispanic, 33% African American), with a mean age of 55 (range 23–86) and predominantly female (69%). In both trial phases, food security scores improved for individuals receiving the intervention and worsened for those not receiving the intervention. On a 12-point Rasch scale, differences between groups ranged from 0.627 points in Phase 1 (95% CI: –1.16, –0.099, P = .02) to 0.879 in Phase 2 (95% CI: –1.46, –0.303, P = 0.003). Conclusions Preliminary results of this cross-over design suggest a causal relationship between healthy food interventions at food banks and improving food security for adults with diabetes. Funding Sources Funding for the Feeding America Intervention Trial for Health—Diabetes Mellitus (FAITH-DM) was provided by Feeding America, the Laura and John Arnold Foundation, the Urban Institute via a Robert Wood Johnson Foundation grant, National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under award P30DK092924, and Centers for Disease Control and Prevention under award 3U48DP004998–01S1. Support for RAR by HRSA QSCERT-PC Program (grant no. T32HP30037).